- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,047.13 / $5,011.87 / $10,964.78
| Facility | | $1,047.13 | $5,011.87 | $10,964.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $354.81 / $537.03 / $1,148.15
| Professional | | $354.81 | $537.03 | $1,148.15 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $389.05 / $467.74 / $660.69
| Professional | | $389.05 | $467.74 | $660.69 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,122.02 / $3,630.78 / $11,220.18
| Facility | | $1,122.02 | $3,630.78 | $11,220.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $323.59 / $426.58 / $489.78
| Professional | | $323.59 | $426.58 | $489.78 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $323.59 / $1,202.26 / $1,412.54
| Facility | | $323.59 | $1,202.26 | $1,412.54 |
- Facility/Professional
- Facility
- Modifier
- AS
- Typical Low / Median / Typical High
- $69.18 / $69.18 / $69.18
| Facility | AS | $69.18 | $69.18 | $69.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $338.84 / $512.86 / $851.14
| Professional | | $338.84 | $512.86 | $851.14 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,466.84 / $9,120.11 / $16,982.44
| Facility | | $4,466.84 | $9,120.11 | $16,982.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $234.42 / $323.59 / $478.63
| Professional | | $234.42 | $323.59 | $478.63 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $616.60
| Professional | | $32.36 | $33.11 | $616.60 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,905.46 / $5,623.41 / $9,772.37
| Facility | | $1,905.46 | $5,623.41 | $9,772.37 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $309.03 / $436.52 / $831.76
| Professional | | $309.03 | $436.52 | $831.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $316.23 / $316.23 / $426.58
| Professional | | $316.23 | $316.23 | $426.58 |